Vous êtes sur la page 1sur 7

1

MZUMBE UNIVERSITY

APPLICATION FORM FOR POSTGRADUATE DEGREE PROGRAMMES

(USE BLOCK LETTERS OR TYPESCRIPT)

This is in response to your application for postgraduate studies at Mzumbe University. Enclosed,
please, find an application form that must be duly filled before your application is processed.
Please, pay special attention to the following points:

Applicant to complete Parts A-F

All information given must be correct (e.g. titles of awards, names of schools, etc.).

All applicable items of this form must be fully completed. Any omission may delay the
processing of the application.

In Part G, the employer is expected to give a brief recommendation of the applicant (for
applicants who are employed and are to be sponsored by their employers).

In Part H, the sponsor's signature for those being sponsored by their employers.

Two reference forms are enclosed and should be filled by academic referees as instructed in Part
E.

Your application will be processed only after your file is complete with all requisite documents
and information.





Affix Photo
2
PART A
PERSONAL PARTICULARS OF THE APPLICANT

1. Surname as it appears in certificate: CHIJENGA
2. Other names: STANFORD_JOFFREY
3. Sex: [ ] Female [X] Male

4. Postal Address: 1056_ TOSCI _ MOROGORO
Mobile: 0655-451-431 Fax: +255-23-2601587 E-mail: stanfordchijenga@gmail.com

Office Tel: +255-23-2600797 _Residence Tel.: ____________________________

5. Marital status: SINGLE

6. Place of birth: MOROGORO
7. Date of birth: 26 DECEMBER 1985

8. Nationality TANZANIAN (by birth __X__ or by naturalization ____) (tick the appropriate)

PART B
THE PROGRAMMME YOU WANT TO APPLY FOR
9. Programmes offered at the three compasses are shown below. Please, check the programme of
your interest and the campus of your choice.

(i) MAIN CAMPUS
Ph.D. [ ]
MBA - Corporate Management .. .. [ ]
MBA - Corporate Management (Evening) .. [ ]
MBA - Corporate Management (Executive) .. .. [ ]
MSc. - Accounting & Finance (A&F).. .. .. [ ]
MSc. - Accounting & Finance (A&F) (Evening).. .. [ ]
MSc. - Entrepreneurship .. .. .. .. [ ]
MSc. - Procurement and Supply Chain Management [ ]
MPA - Master of Public Administration .. .. [ ]
MHSM- Master of Health Systems Management .. [ ]
MSc. -Health Monitoring and Evaluation.. .. [ ]
MSc. - Human Resource Management .. .. [ X ]
MSc. - Local Government Management .. .. [ ]
Msc. Master of Research and Public Policy [ ]
MSc - Development Policy .. .. .. [ ]
MSc. - Environmental Management [ ]
MSc - Economics .. .. .. .. .. [ ]
MSc. - Project Planning and Management .. ... [ ]
MSc. -Economics Policy and Planning .. .. .. [ ]
LL.M - Constitutional & Administrative Law .. [ ]
LL.M - Commercial Law .. .. [ ]
LL.M - International Law .. .. .. .. [ ]



3

Preferred mode of delivery you want (except for Ph.D):
Morning class (only available on campus) X
Evening class (for MBA and MSc. A&F) at Morogoro Municipality: _________________
Executive mode _________________

Please note that choosing a morning class means the course will be pursued at the main
campus while choosing an evening class implies the course will be pursued at Down Town
Morogoro. Courses offered under evening mode at the Morogoro Municipality are MBA and
MSc. A&F only. Please, note that the same courses are also offered as morning (or ordinary)
classes on campus. The executive mode at the Main Campus is for MBA only and it is not
offered as an evening class at the Municipality. It will be offered only when there are enough
applicants.

(ii) DAR ES SALAAM CAMPUS COLLEGE:

Ph.D. .. .. .. .. .. .. .. [ ]
MBA - Corporate Management .. .. .. [ ]
MBA - Corporate Management (Executive Mode) .. .. [ ]
MSc. - Accounting & Finance (A&F).. .. .. .. [ ]
MSc. - Marketing Management .. .. .. .. [ ]
MSc. - Procurement and Supply Chain Management .. [ ]
MPA - Master of Public Administration .. .. .. [ ]
MPA - Master of Public Administration (Executive Mode) .. [ ]
MSc. - Human Resource Management .. .. .. [ ]
MSc. - Human Resource Management: Executive Mode .. [ ]


Mode:
Morning class: _______________________
Evening: _______________________
Executive _______________________

Please note:
Executive mode at the Dar es Salaam Campus College is offered for MBA and MPA
programmes only.

(iii) MBEYA CAMPUS COLLEGE:

MBA - Corporate Management (Executive Mode) .. [ ]
MBA - Corporate Management (Evening Mode) .. [ ]

11. Name of present employer (if applicable) TANZANIA OFFICIAL SEED
CERTIFICATION INSTITUTE (TOSCI)


12. Your present title or position: HUMAN RESOURCE OFFICER II


4
PART C
ACADEMIC TRAINING

13. Please, list all high schools, colleges, universities or other educational institutions you
attended.
School/College/
University
Country Years Major Field of
Study
Certificate/Diplomas/
Degrees awarded
From To
FOREST HILL
SECONDARY
SCHOOL
TANZANIA 2004 2006 (HGE)-
HISTORY,
GEOGRAPHY
AND
ECONOMICS
ADVANCED
SECONDARY
SCHOOL
EDUCATION
CERTIFICATE
KAMPALA
UNIVERSITY
UGANDA 2006 2009 HUMAN
RESOURCE
MANAGEMENT
DEGREE




PART D
PROFESSIONAL EXPERIENCE

14. List all jobs held for the past three years (if applicable)

Position: HUMAN RESOURCE OFFICER II
Company/organization: TANZANIA OFFICIAL SEED CERTIFICATION INSTITUTE
(TOSCI)
Duration: 2010 TO DATE
Brief job description: HR PLANNING AND TRAINING NEEDS ASSESMENT,
PREPARING ACCURATE STAFF RECORDS, ANNUAL EMPLOYEES
ESTABLISHMENT AND PERSONAL EMOLUMENTS ESTIMATES, ADMINISTERING
EMPLOYEES SALARIES, DEALING WITH HUMAN RESOURCE REQUIREMENTS
AND RECRUITMENT, ENTERPRETING PUBLIC SERVICE ACTS, REGULATIONS
AND POLICIES AND ITS IMPLEMENTATION ET CETERA.

Position: ____________________________________________________________
Company/organization: ________________________________________________
Duration: ____________________________________________________________
Brief job description: ______________________________________________________
______________________________________________________
Position: ____________________________________________________________
Company/organization: ________________________________________________
Duration: ____________________________________________________________
Brief job description: _____________________________________________________
_____________________________________________________

5
PART E
ACADEMIC REFEREES

15 Please provide names of two academic referees and ensure that they each complete the
attached reference form. The form should be sealed (signed on the closing envelope flaps)
by the referee and returned by the applicant together with the application form.

Name of Referee Address Affiliation
(i) DR CHARLES TUNDUI_ 5, DEPT OF ECONOMICS, MZUMBE UNIVERSITY__MENTOR
(ii) DR FRED ALFRED RWECHUNGURA_5, DEPT OF ECONOMICS, MZUMBE UNIVERSITY_ MENTOR

PART F

CERTIFICATION

16. I certify that the information given in this application form is complete and accurate to the
best of my knowledge.

______________________ 14, MARCH 2013
Signature of applicant Date


PART G
EMPLOYER'S OR SPONSORS APPRAISAL (WHERE APPLICABLE)

17. Rating of applicant: Please, tick

Excellent Very
good
Good Poor Very
poor
Knowledge of job performed
Ability to learn
Personal initiative
Co-operation and personal interaction
Judgement and common sense

General conduct:
________________________________________________________________________
_______________________________________________________________________

6
PART H
SPONSORSHIP COMMITMENT, WHERE APPLICABLE

18. This is to certify that_____________ ___________________________________
is sponsored by us for the programme of study he/she has applied for and we undertake to
meet total/part of the programme costs as given by the University.

_______________________ ___________________________________
DATE SIGNATURE OF THE SPONSOR

[OFFICIAL STAMP IF APPLICABLE]

Duly filled application forms should be sent to the respective campuses as follows:-

For the Main Campus:
DIRECTOR
DIRECTORATE OF RESEARCH, PUBLICATIONS, & POSTGRADUATE STUDIES
P. O. BOX 63
MZUMBE, TANZANIA
Tel. +255 23 2604380/1/3/4
Fax: +255 23 2604382

For Dar es Salaam Campus College:
PRINCIPAL
DAR ES SALAAM CAMPUS COLLEGE
P. O. BOX 20266,
DAR ES SALAAM, TANZANIA
Tel. +255 22 2152586/2152584
Fax: +255 22 2152584

For Mbeya Campus College:
PRINCIPAL
MBEYA CAMPUS COLLEGE
MBEYA, TANZANIA
P. O. BOX 6559,
TEL. +255 25 2502863
FAX.+255 25 2502862

For Mwanza Training Centre:

Mr. Gilead Mchaki (Contact Person)
Tel. 0767 664308 or 0784 741303

OR

DEAN
School of Business
P.O.Box 6
MZUMBE



For Tanga Training Centre
7

DEAN
School of Business
P.O.Box 6
MZUMBE



Please note:
This application should be accompanied by an application fee of Tshs 30,000
whose pay in slip should be attached with these forms. The fee is payable to
Mzumbe University, CRDB Account No. 01J1012013400 for those applying
at the Main Campus; Mzumbe University, CRDB Account No.
01J1043012201 for those applying at the Dar es Salaam Campus College;
and Mzumbe University, CRDB Account No. 01J1065743701 for those
applying at the Mbeya Campus.

Vous aimerez peut-être aussi